A Texas-Size Health Insurance Mandate For Heart Tests

Republican presidential candidate Gov. Rick Perry of Texas prepares to speak at a dinner in Bettendorf, Iowa, Monday. Two years ago Perry signed into Texas law an insurance mandate covering controversial tests for heart disease.

Charlie Neibergall
/ AP

Originally published on November 16, 2011 11:38 am

Everything's big in Texas. Even health insurance mandates, it seems.

The Center for Public Integrity is out with a story about a Texas law that made it mandatory for health insurers to reimburse patients up to $200 for CT scans and ultrasound tests to look for heart trouble.

Gov. Rick Perry signed the 2009 bill into law, a position the CPI story suggests is at odds with his general stance against government intrusion.

The requirement applies to people middle-aged and up who are either diabetic or at least intermediate risk for heart disease. That adds up to about 2.4 million people whose first tests would cost about $480 million by one estimate.

Only one problem with the law, wrote Amit Khera, a cardiologist at Universityof Texas Southwestern Medical Center in Dallas, in the Archives of Internal Medicine this February:

"While atherosclerosis imaging tests may someday play a valuable role in broader screening for [cardiovascular disease] risk, the current data supporting population-level implementation of these tests are far from sufficient to warrant legislative action."

In an editor's note, Dr. Rita Redberg added that "no data demonstrate that screening" with these methods reduces illnesses or deaths from coronary disease, yet there are "significant risks of increased cancer" and lots more testing associated with them. "At a time when states are facing crises in health insurance spending and cutting lifesaving treatments, and when Texas leads the nation in the percentage of residents without health insurance, it is remarkable that Texas has chosen this path," she wrote.

And it's not the first such mandate in the state. The CPI story says Texas is No. 4 in the nation when it comes health insurance mandates.

The CPI story probes reasons why Perry might have supported the testing mandate, including winning support from Pfizer, maker of cholesterol-fighert Lipitor. "A Perry spokesman declined to address the issues raised by Pfizer's support," the story says. But the piece notes he's previously called "ridiculous" the notion that he had sought donations in return for special benefits.

Perry, you might recall, supported mandatory HPV vaccination of Texas schoolgirls, a stand that helped drugmaker Merck but that the state legislature overturned. And as NPR's Peter Overby reported, the actual financial benefit to Perry's campaigns from Merck donations were greater than the $5,000 he acknowledged in a faceoff with Rep. Michele Bachmann during a GOP debate in September.